Global & Disaster Medicine

Archive for the ‘Water’ Category

“……..Background
Over the past few years, several studies have reported the presence of microplastics in treated tap and bottled water, raising questions and concerns about the impact that microplastics in drinking-water might have on human health. This report, which contains a summary of the evidence, key findings, recommendations and research needs, is the World Health Organization’s (WHO) first effort to examine the potential human health risks associated with exposure to microplastics in the environment. The focus of this report is on the potential human health impacts of exposure to microplastics through drinking-water. However, brief information on other routes of human exposure is included for context.
This report was informed by literature reviews undertaken on the occurrence of microplastics in the water cycle, the potential health impacts from microplastic exposure and the removal of microplastics during wastewater and drinking-water treatment. Throughout the report, WHO experts examined the quality and relevance of the studies they found. The report was also informed by reviews conducted by several major entities; these are referenced throughout the report.
As a category, microplastics encompass a wide range of materials with different chemical compositions, shapes, colours, sizes and densities. There is no scientifically-agreed definition of microplastics, although most definitions focus on composition and size. ………

“……Recommendations
Routine monitoring of microplastics in drinking-water is not recommended at this time, as there is no evidence to indicate a human health concern. Concerns over microplastics in drinking-water should not divert resources of water suppliers and regulators from removing microbial pathogens, which remains the most significant risk to human health from drinking-water along with other chemical priorities. As part of water safety planning, water suppliers should ensure that control measures are effective and should optimize water treatment processes for particle removal and microbial safety, which will incidentally improve the removal of microplastic particles.
However, for researchers, it would be appropriate to undertake targeted, welldesigned and quality-controlled investigative studies to better understand the sources and occurrence of microplastics in fresh water and drinking-water, the efficacy of different treatment processes and combinations of processes, and the significance
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of the potential return of microplastics to the environment from treatment waste streams including the application of sludge biosolids to agricultural land.
Measures should also be taken to better manage plastics and reduce the use of plastics where possible, to minimize plastic and microplastic pollution despite the low human health risk posed by exposure to microplastics in drinking-water, as such actions can confer other benefits to the environment and human well-being.

Research needs
To better assess human health risks and inform management actions, a number of research gaps need to be filled. With respect to exposure, there is a need to better understand microplastics occurrence throughout the water supply chain, using quality assured methods to determine the numbers, shapes, sizes, composition and sources of microplastics and to better characterize the effectiveness of water treatment. Research is also needed to better understand the significance of treatment-related waste streams as contributors of microplastics to the environment.
With respect to potential health effects, quality-assured toxicological data are needed on the most common forms of plastic particles relevant for human health risk assessment. Further, a better understanding on the uptake and fate of microplastics and nanoplastics following ingestion is needed.
Finally, given that humans can be exposed to microplastics through a variety of environmental media, including food and air, a better understanding of overall exposure to microplastics from the broader environment is needed.

“…..Chennai was one of 21 cities the think-tank said could run out of ground water by 2020 and this week, taps ran dry as water levels in its four major reservoirs fell to one-hundredth of what they were this time last year.

The crisis in the southern coastal city has pushed schools, hotels and commercial establishments to close, while hospitals have put off non-essential surgeries…..”

The WHO/UNICEF JMP report, WASH in Health Care Facilities, is the first comprehensive global assessment of water, sanitation and hygiene (WASH) in health care facilities. It also finds that 1 in 5 health care facilities has no sanitation service*, impacting 1.5 billion people. The report further reveals that many health centres lack basic facilities for hand hygiene and safe segregation and disposal of health care waste.

These services are crucial to preventing infections, reducing the spread of antimicrobial resistance and providing quality care, particularly for safe childbirth.

â€œWater, sanitation and hygiene services in health facilities are the most basic requirements of infection prevention and control, and of quality care. They are fundamental to respecting the dignity and human rights of every person who seeks health care and of health workers themselves,â€ said AntÃ³nio Guterres, United Nations Secretary-General.Â â€œI call on people everywhere to support action for WASH in all health care facilities.Â This is essential to achieve the Sustainable Development Goals.â€

The WHO/UNICEF JMP report found that just half â€“ 55 per cent â€“ of health care facilities in Least Developed Countries (LDCs) had basic water services. It is estimated that 1 in 5 births globally takes place in LDCs, and that, each year, 17 million women in these countries give birth in health centres with inadequate water, sanitation and hygiene.

â€œWhen a baby is born in a health facility without adequate water, sanitation and hygiene, the risk of infection and death for both the mother and the baby is high,â€ said UNICEF Executive Director Henrietta Fore. â€œEvery birth should be supported by a safe pair of hands, washed with soap and water, using sterile equipment, in a clean environment.â€

In an accompanying report, Water, sanitation, and hygiene in health care facilities: Practical steps to achieve universal access for quality care, WHO and UNICEF researchers note that more than 1 million deaths each year are associated with unclean births. Infections account for 26% of neonatal deaths and 11% of maternal mortality.

â€œImagine giving birth or taking your sick child to a health centre with no safe water, toilets or handwashing facilities,â€ said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. â€œThatâ€™s the reality for millions of people every day. No one should have to do that, and no health worker should have to provide care in those circumstances. Ensuring that all health care facilities have basic water, sanitation and hygiene services is essential for achieving a healthier, safer, fairer world.â€

At the 2019 World Health Assembly to be held in May, governments will debate a resolution on Water, Sanitation and Hygiene in Health Care Facilities which was unanimously approved by the WHO Executive Board earlier this year.

The WHO and UNICEF Practical Steps report provides details on eight actions governments can take to improve the WASH services in health care facilities including establishing national plans and targets, improving infrastructure and maintenance and engaging communities. These actions and resulting improvements in WASH services can yield dramatic returns on investment in the form of improved maternal and newborn health, preventing antimicrobial resistance, stopping disease outbreaks and improving quality of care.

According to UNICEF, 7,000 newborn babies died every day in 2017, mostly from preventable and treatable conditions including infections like sepsis. As part of its Every Child Alive Campaign, UNICEF is calling for governments and authorities to make sure every mother and baby have access to affordable, quality care.Â

Last year, Fore and Dr Tedros called on countries to strengthen their primary health care systems as an essential step toward achieving universal health coverage.

“…….Desalination facilities, which extract drinkable water from the ocean, discharge around 142 billion liters of extremely salty water called brine back into the environment every day, a study finds. That waste product of the desalination process can kill marine life and detrimentally alter the planet’s oceans…..”

“….The world’s roughly 150,000 glaciers, not including the large ice sheets of Greenland and Antarctica, cover about 200,000 square miles of the earth’s surface. Over the last four decades they’ve lost the equivalent of a layer of ice 70 feet thick…..”

“……On January 1, 2018, the city announced an official limit for sustainable water use of 450 million liters per day for the entire province and declared Level 6 water restrictions, capping household water use at 50 liters per residence per day. Over 6 months, the city issued tenders to build 3 emergency desalination plants, and reduced agricultural use by 60%. The city raised funding to research water saving and recovery technologies and water source diversification—moving away from reliance on the city’s dwindling reservoirs as the main water source…..”